Provider Network Data Maintenance Associate

PacificSource; Springfield (OR); On-site; USD 36,000 - 57,000; Full time

Benefits offered by this job

Flexible telecommute policy

Medical insurance

Vision insurance

Dental insurance

401(k) plan

Paid time off

Holidays

Life insurance

Flexible spending account

Tuition reimbursement

Job summary

PacificSource is seeking a Provider Network Maintenance Associate to ensure accurate provider data, compliance with regulations, and timely reimbursements. You will work with Provider Relations, Credentialing, and Contracting teams to manage provider records and directories.

Required 2+ years in an office setting, strong data entry skills, and familiarity with healthcare terminology; high school diploma required, degree preferred. Flexible telecommute policy and competitive benefits offered.

Qualifications

• Minimum 2 years of office experience required; healthcare data background preferred.
• Strong data entry accuracy and attention to detail.
• Ability to learn new systems, databases, and applications with minimal supervision.

Responsibilities

• Enter and update provider demographic, credentialing, and contract data in PacificSource systems.
• Process provider additions, terminations, and changes to maintain data integrity and accurate payments.
• Regularly audit provider data for accuracy and regulatory compliance.
• Assist in managing provider directories to ensure current information.
• Verify licensure, Medicare, and Medicaid eligibility using approved tools.
• Support monitoring of provider records for policy and contracting compliance.
• Collaborate with Provider Relations, Credentialing, Contracting, and other teams to resolve data issues.
• Communicate with providers to obtain missing documents and clarify discrepancies.
• Contribute to process improvements in data entry and maintenance.

Skills

Data entry

Communication

Computer skills

10-key

Medical terminology

CPT/ICD-10 knowledge

Education

High School Diploma or equivalent

Associate's or Bachelor's degree preferred

Job description

Looking for a way to make an impact and help people? Join PacificSource and help our members access quality, affordable care! PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person’s talents and strengths.

The Provider Network Maintenance Associate is responsible for maintaining the accuracy and integrity of provider data within the organization's systems. This role involves updating provider records, ensuring compliance with all regulatory requirements, and supporting Provider Network Operations by managing data related to provider contracts, reimbursements, and credentialing. The Associate will work closely with various teams, including Provider Relations, Provider Reimbursement Analytics, Provider Network Credentialing and Compliance, to ensure that provider information is up-to-date and accurate, which is critical for smooth operations and timely reimbursements.

Essential Responsibilities

• Accurately and promptly enter and update provider demographic, credentialing, and contract information in PacificSource systems for new and re-credentialed network providers, meeting department service level expectations.
• Process provider additions, terminations, and changes in a timely manner to maintain data integrity and ensure accurate contract rows are added for correct claims payments.
• Perform regular audits of provider data to ensure accuracy, compliance with internal standards, regulatory requirements, and support ongoing maintenance and data integrity of provider information.
• Assist in the management of provider directories, ensuring they are current, accurate, and meet the needs of members.
• Verify licensure, Medicare, and Medicaid eligibility using compliance-approved tools, ensuring provider data meets all regulatory and accreditation standards, including state and federal requirements.
• Support the monitoring and maintenance of provider records for compliance with organizational policies, procedures, and contracting regulations.
• Collaborate with Provider Relations, Credentialing, Contracting, and other internal teams to resolve provider data issues, and research and respond to detailed provider inquiry issues routed from customer/provider service departments.
• Communicate with providers to obtain necessary documentation or clarify discrepancies in data, ensuring positive and effective working relationships.
• Provide support and assistance to other team members as needed to ensure the overall effectiveness of the provider network operations.
• Identify opportunities for process improvements related to provider data management, maintenance, and contribute to quality assurance initiatives to continuously improve data accuracy and process efficiency.
• Assist in the development and implementation of best practices for provider data entry and maintenance, and participate in projects related to provider network expansion, system upgrades, or regulatory changes.
• Maintain positive and effective working relationships with team members and other departments.

Supporting Responsibilities

• Meet department and company performance and attendance expectations, maintaining a high level of data accuracy and productivity.
• Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.
• Perform other duties as assigned, contributing to the overall success of the Provider Network Department.

SUCCESS PROFILE

• Work Experience: A minimum of 2 years of experience in an office environment is required, preferred experience in healthcare data management, network operations or data analysis.
• Preferred familiarity with provider network operations included, but not limited to, provider credentialing, healthcare regulatory requirements, contracting or reimbursement processes.
• Education, Certificates, Licenses: High School Diploma or equivalent required, Associate’s or Bachelor’s degree preferred.
• Knowledge: Fast and accurate data entry skills. Self-motivated. Able to learn and be trained on new systems, databases, and applications Effective written and oral communication. Proficient computer skills, typing, and 10-key required. Medical terminology, CPT/ICD-10 coding preferred.
• Competencies: Adaptability Building Customer Loyalty Building Strategic Work Relationships Building Trust Continuous Improvement Contributing to Team Success Planning and Organizing Work Standards
• Environment: Work inside in a general office setting with ergonomically configured equipment. Travel may be required 5% of the time for training and/or external meetings.
• Skills: Accountability, Collaboration, Communication (written/verbal), Flexibility, Listening (active), Organizational skills/Planning and Organization, Problem Solving, Teamwork

Compensation Disclaimer

The wage range provided reflects the full range for this position. The maximum amount listed represents the highest possible salary for the role and should not be interpreted as a typical starting wage. Actual compensation will be determined based on factors such as qualifications, experience, education, and internal equity. Please note that the stated range is for informational purposes only and does not constitute a guarantee of any specific salary within that range.

Base Range: $35,542.81 - $56,868.50

Our Values

We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business: We are committed to doing the right thing. We are one team working toward a common goal. We are each responsible for customer service. We practice open communication at all levels of the company to foster individual, team and company growth. We actively participate in efforts to improve our many communities-internally and externally. We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community. We encourage creativity, innovation, and the pursuit of excellence.

Physical Requirements

• Stoop and bend.
• Sit and/or stand for extended periods of time while performing core job functions.
• Repetitive motions to include typing, sorting and filing.
• Light lifting and carrying of files and business materials.
• Ability to read and comprehend both written and spoken English.
• Communicate clearly and effectively.

Benefits

• Flexible telecommute policy, medical, vision, and dental insurance, incentive program, paid time off and holidays, 401(k) plan, volunteer opportunities, tuition reimbursement and training, life insurance, and options such as a flexible spending account.

We love our common purpose. Empowerment, flexibility, and sharing success make for a great place to work. Here’s what else we feel good about: A mission with a real sense of shared values Competitive wages and outstanding benefits, including telecommuting Opportunities for learning development and career advancement Organizational leadership style rooted in servant and transformational leadership A commitment to support the communities we serve A belief in the importance of work-life balance Stay tuned! More to come soon!

PacificSource is anything but a typical health insurance company. Founded in 1933, we’re an independent, not-for-profit organization that puts our members, and their communities first—across Idaho, Oregon, Montana, and Washington. It's our employees who make it happen: promoting health equity and partnering with providers to deliver better access to optimal, affordable care. So yes, with PacificSource, you get to do great things. In our effort to put members first—more than 525,000 of them—initiative, commitment, and hard work are supported and rewarded with excellent benefits, competitive wages, and opportunities for personal growth and advancement.

Top Workplace 2026, 2025 and 2024 USA | USA Today 2025 Healthcare Top Workplaces | Energage Top Workplaces # 6 Healthiest Employer of Oregon 2025 | Portland Business Journal Top Workplace 2024, 2023 and 2022 for Oregon and SW Washington | The Oregonian Top Workplace 2025, 2024, 2023 and 2022 for the Treasure Valley | Idaho Press Certified Age Friendly Employer, 2023 | Age Friendly Institute

PacificSource is an equal opportunity employer and a company that loves helping people. We work with our employees to understand their goals, and provide training, individual development, and career advancement opportunities to help them achieve just that.

PacificSource is an equal opportunity employer. Click here to review our AAP Policy Statement. If you have questions about working at PacificSource or need help with your application, please email [e-mail].